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Prepare for Pregnancy After-Pains

Thursday, September 27th, 2012

You already know about the pains associated with pregnancy.  The discomfort you feel in the months leading up to your due date don’t end once you give birth though.  This is where many women are caught off guard when they learn that a week or two of healing after their delivery doesn’t leave them completely pain free.

When you consider the dramatic shift your body has experienced throughout your pregnancy, it shouldn’t be too surprising that it will take it awhile to get back to normal.  Your weight isn’t the only thing that will take a while to reset though.  After all that tightness, stretching, and pulling, your muscles, ligaments, and skin have been through a lot, and that will make them sore for some time.  As these areas adjust, so too will your uterus, as it contracts back up into its original size and location.  This process can take up to six weeks, and during that time (especially during breast feeding), you may feel after-pains from this movement.  Urinating regularly can help relieve some of this discomfort.  If you received any stitches, these will obviously be a bother and will take time to heal.  Your swollen breasts will also be sore, and the nipples will probably get even more painful as they adjust to your child’s frequent feeding schedule.  Your entire body will need to rebalance, and the if you had back pain from carrying the baby the last few months of pregnancy, it may take a couple more to ease the discomfort .  Getting in shape will help speed this along, but don’t push yourself too much.  You’re allowed some time to recuperate.

If you’ve already discovered these lasting pains and are trying to find ways to endure, there are a few pain relieving strategies you can try.  Sitz baths, ice packs, wash bottles, and massages are supportive measures for postpartum pain.  However, a new mom should not deprive herself of effective pain medication, such as extra-strength Tylenol, ibuprofen or prescription pain medications given by her doctor, even if she is breastfeeding.  If you’re in very intense pain though, speak with your physician to make sure there isn’t a more serious issue.  They may have advice for other safe pain relieving methods too.  Otherwise, welcome to the joy and pain of parenthood!

 – Yvonne S. Thornton, M. D., M. P. H.

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Prepare for Pregnancy After-Pains

Thursday, September 13th, 2012

You already know about the pains associated with pregnancy.  The discomfort you feel in the months leading up to your due date don’t end once you give birth though.  This is where many women are caught off guard when they learn that a week or two of healing after their delivery doesn’t leave them completely pain free.

When you consider the dramatic shift your body has experienced throughout your pregnancy, it shouldn’t be too surprising that it will take it awhile to get back to normal.  Your weight isn’t the only thing that will take a while to reset though.  After all that tightness, stretching, and pulling, your muscles, ligaments, and skin have been through a lot, and that will make them sore for some time.  As these areas adjust, so too will your uterus, as it contracts back up into its original size and location.  This process can take up to six weeks, and during that time (especially during breast feeding), you may feel after-pains from this movement.  Urinating regularly can help relieve some of this discomfort.  If you received any stitches, these will obviously be a bother and will take time to heal.  Your swollen breasts will also be sore, and the nipples will probably get even more painful as they adjust to your child’s frequent feeding schedule.  Your entire body will need to rebalance, and the if you had back pain from carrying the baby the last few months of pregnancy, it may take a couple more to ease the discomfort .  Getting in shape will help speed this along, but don’t push yourself too much.  You’re allowed some time to recuperate.

If you’ve already discovered these lasting pains and are trying to find ways to endure, there are a few pain relieving strategies you can try.  Sitz baths, ice packs, wash bottles, and massages [http://www.webmd.com/parenting/baby/news/20041103/pain-after-childbirth-common-often-untreated]  are supportive measures for postpartum pain.  However, a new mom should not deprive herself of effective pain medication, such as extra-strength Tylenol, ibuprofen or prescription pain medications given by her doctor, even if she is breastfeeding.  If you’re in very intense pain though, speak with your physician to make sure there isn’t a more serious issue.  They may have advice for other safe pain relieving methods too.  Otherwise, welcome to the joy and pain of parenthood!

 – Yvonne S. Thornton, M. D., M. P. H.

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Legitimate Rape or Legitimate Ignorance?

Thursday, September 6th, 2012

In February, there was a hearing chaired by Daryl Issa for the House Committee on Oversight and Government Reform Hearing on the Contraceptive Coverage Rule.  Unfortunately, the panel was entirely male.  Talk about oversight!  This prompted many female members of congress to walk out of the hearing in protest, much to the confusion of the chair.  When asked about the walkout, Senator Kirsten Gillibrand said, “If our republican colleagues want to continue to take this issue head on, we will stand here as long as necessary.”  In August, women received a fresh reminder of the Republican male’s perspective on rape when Representative Tod Akin proclaimed, “If it’s a legitimate rape, the female body has ways to try to shut that whole thing down.”

Women around the world are wondering what constitutes the difference between rape and legitimate rape.  John C. Wilke, who is not an obstetrician, but a general practitioner of almost 90 years old, and who is the former President of the National Right to Life Committee is the only doctor who supports Akin’s remarks regarding whether or not the reproductive system of a woman shuts down during rape.  With such credentials, it goes without saying that he may have a bias and outdated view of rape and the female body, and experts disagree with his supposedly medical explanation for his belief.  In fact, one in 15 raped women become pregnant, no matter what definition of rape you choose.  Are Akin and Wilke suggesting that those rapes were not legitimate?  I doubt it seemed that way to the women when it was happening.

The most disconcerting part of all of this is that representative Akin has the power to influence laws in our country.  In this day and age, we hope that men have at least the decency and empathy to listen to the voices of women in our country, and, heaven forbid, include us in panels and decision-making regarding our own reproductive rights.  Hopefully, there are a lot of women and understanding men out there willing to make their vote count in order to make a positive change for all of us.  I wonder, is it pure prejudice keeping men like Akin in the dark when it comes to women’s health issues and reproductive rights, or is it legitimate ignorance?

 

– Yvonne S. Thornton, M. D., M. P. H.

Posted in Childbirth & delivery, Contraception (birth control), Fertility & Infertility, General health news, Health care policy, Pregnancy, Women's health news | No Responses »
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Inside Information for Women – Todd Aiken? What Does He Know.

Friday, August 31st, 2012

Senator Todd Aiken – Is there a man in America who has unleashed such fury among women in the recent past? The words “legitimate” and “rape” should never even appear in close proximity to one another, let alone in the same sentence, connected to one another. The fact that he is still running in his election only proves how uneducated and behind-the-times he is. The sad thing about this is, regardless of his uneducated statements, there are still MANY people that will try to take a woman’s decision to choose away from her. We live in this country because we want the right to choose and the freedom of religion. That freedom to practice your own religion and choices means that you cannot force your opinions on others.

My most recent radio show speaks to this entire subject. Please listen and enjoy. I look forward to your comments.

 

Yvonne S. Thornton, M. D., M. P. H.

INSIDE INFORMATION FOR WOMEN 8-30-12

Posted in Childbirth & delivery, Pregnancy, Women's health issues, Women's health news | No Responses »

Chocolate is the Caffeine of Choice for Moms to Be

Thursday, August 30th, 2012

When you get pregnant, you want to do everything you can to ensure the safety of your developing baby.  For this reason, most moms cut out foods, drinks, and chemicals that might have adverse effects on their baby.  Caffeine is just one thing they often give up, which means no more tall daily lattes or espressos.  Although high levels of caffeine can be dangerous, small amounts are fine, and one study found that the levels of caffeine found in chocolate are safe for moms and their unborn babies.

Many experts agree that moms should avoid taking in any more than 200 mg of caffeine per day.  This allows for a small cup of coffee, but most women still choose to avoid it altogether, which is probably a good idea, unless you need it as a stimulant for bowel regularity.  You never know how much caffeine a particular brew of coffee might hold, and it’s always better to be safe than sorry. When pregnancy has you craving something sweet though, you might forget that chocolate too contains caffeine.

Fetal heart rate reactivity is a medical term that describes how reactive the baby’s heart rate is when it is moving around in utero.  With fetal movement, the fetal heart rate accelerates about 15 beats per minute and is a sign of fetal well-being.  Fetal reactivity assessment is used as a surveillance tool when we are worried about the baby in a Mom who may have hypertension or diabetes (known as a nonstress test or NST).  The more “reactive” the fetal heart rate is, the better.   A study published in the Journal of Maternal-Fetal and Neonatal Medicine determined that eating chocolate can make the fetal heart rate more reactive .  This increased heart rate did not appear to be from the caffeine in chocolate, but rather from the theobromine, which dilates blood vessels and decreases blood pressure.  In order to make up for this physiologic change, your heart and also your baby’s heart have to pick up the pace in order to maintain adequate blood circulation, resulting in a more reactive fetal heart rate pattern, which is a good thing.

However, as with any chemical, food or supplement that alters your body function, it should be taken in moderation.  In other words, don’t go overboard, but don’t feel the need to pass up on a “chocolate moment” to satisfy those cravings once in a while either.

 

– Yvonne S. Thornton, M. D., M. P. H.

Posted in Childbirth & delivery, Pregnancy, Women's health news, Your newborn baby | No Responses »
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Don’t Rush Your Delivery

Monday, August 27th, 2012

While being pregnant is a blessing, how you feel while pregnant is hardly ever comfortable or convenient.  As your delivery date approaches, this will become even more true.  That doesn’t mean it’s a good idea to rush your delivery though.  In fact, rushing your delivery could lead to serious problems that would make life after your pregnancy even more inconvenient.  Let me clarify the definition of a full-term pregnancy.  A full-term pregnancy is between 38 weeks, 0 days and 42 weeks, 6 days.  Yes, four weeks!  Mother Nature gives the baby four weeks to make up its mind to exit the padded “condo”.  With that said, recent neonatal literature (http://journals.lww.com/greenjournal/Abstract/2011/11000/Neonatal_Outcomes_After_Implementation_of.12.aspx) has concluded that babies who are delivered before the 39th week of gestation are significantly at risk for neurological deficits and respiratory problems.

Unfortunately, we have become a society of convenience.  Consequently, there has been an increase in the number of births by early induction of labor lately.  While it’s true that if there is medical reason to induce labor early, it can be a necessity, that does not mean it is safe or recommended for everyone.  In some cases, couples decide that they would like their baby to be born on a special date for future birthdays.  For others, it is because a father might be leaving for a while and would otherwise miss the birth of his child.  In still other cases, doctors actually recommend early induction simply because they are hoping to have the holiday off or don’t want to be called away from their vacation should delivery come later than the expected due date.  A study by the Agency for Healthcare Research and Quality concerning the results of elective induction once again confirm the dangers involved.  Inducing labor before your baby is ready, can cause serious problems that could harm his or her physical and mental development.  Those developmental issues could affect them for the rest of their life.  Also, babies born too early often have to stay in the hospital longer and sometimes must spend that time in intensive care.  The March of Dimes has supported this study and is now strongly opposing early elective delivery before 39 weeks.

Although you and your doctor might be itching to get that baby out and into the world, that is no reason to induce labor.  If it becomes medically necessary to do so, then it can be done safely, but the risks are still increased.  If your doctor urges you to induce labor without a medical reason, seek a second opinion.  If it’s just your impatience pulling you in that direction, be patient.  You’ll have plenty of time with your little one soon enough, and by waiting for your baby’s natural delivery date, the time you get with them will be of a much better quality.

 

– Yvonne S. Thornton, M. D., M. P. H.

Posted in Childbirth & delivery, Pregnancy, Women's health issues, Women's health news, Your newborn baby | No Responses »
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West Nile Virus Without the Bite

Thursday, August 23rd, 2012

Another West Nile Virus scare is sweeping the nation.  In fact, many regions have declared states of emergency due to the number of infected people in their area.  This has led to more spraying and other strategies meant to kill mosquitos carrying the virus and to prevent them from breeding further this year.  It’s not just the bite of those mosquitos that can transmit the virus though, which is making some mothers nervous.

Approximately, two weeks after being bitten by a mosquito carrying the West Nile, the virus finishes its incubation period and the infected person may start noticing symptoms.  Although they cannot transmit the disease through any sort of casual contact, there are a few ways someone could accidentally pass the illness on to someone else.  This can occur as a result of blood transfusions and organ transplants, telling us that the blood plays a major role in transmission.  That also means that mothers can pass the virus from their blood to their unborn babies or even to a baby they are breastfeeding.  This is not common, as least as far as documentation shows, but it is possible.  If you are pregnant or breastfeeding and have begun to feel ill after being bitten by a mosquito in the past couple of weeks, you may want to speak to your physician just to make sure it is not West Nile.  While some people never develop symptoms, those with compromised or delicate immune systems, such as the elderly, babies, and pregnant women, could contract more severe cases with symptoms like swollen lymph nodes, rashes, fever, aches, and nausea.  In a small percentage of cases, the virus is fatal, but this is rare when it is caught and treated early.

For the most part, this West Nile scare is exactly that- a scare.  In truth, more people die every year from the common flu than from any outbreak of West Nile thus far.  However, that doesn’t mean you should ignore any symptoms if you suspect you may have it, especially if you are pregnant.  In the meantime, get rid of standing water near your home, stay inside during dusk and dawn hours, and wear a safe repellent if you think you will likely be around mosquitos.  When you’re carrying or caring for your baby, it’s always better to be safe than sorry.

 

– Yvonne S. Thornton, M. D., M. P. H.

 

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Don’t Forget to Ask

Monday, August 6th, 2012

When you are pregnant, there are a lot of things running through your mind at once, most of them being questions.  As the date of delivery approaches, those questions become all the more important and all the more difficult to remember to ask.  Here are a few important ones that you should add to your list.

What if My Doctor’s Unavailable?

Although your physician may have set a due date, that is only a best guess as to when you will actually deliver.  Normally, your doctor will try to be available for a delivery in the week before and after that date.  However, extenuating circumstances or a very early delivery could cause them to be unavailable when you need them.  Instead of panicking when the time comes and taking whoever happens to be available, plan for this situation ahead of time.  Speak with your doctor about potential back-ups.  Ask who they recommend and if you can get their numbers for your on-call list.  It might also be a good idea to meet them, so if they do end up delivering your baby, you will have already established a relationship with them, making for a more comfortable experience.

 Who Can Come with Me?

Back in the day, women would bear their pain alone but for the doctors and nurses in the delivery room, but now, most moms want to bring in the father, or at least some trusted family member or friend.  For a standard delivery, this shouldn’t be a problem, but if there are complications, they may be asked to leave so that doctors have more room to work.  Normally, they will ask you to restrict access to the delivery room to one or two people and with all the chaos birth can bring, you’ll appreciate not having too many people around.  If you will be having a C-Section surgery though, having someone in the delivery room may or may not be possible.  Be sure to ask before promising access to anyone.

 Will Someone Be There to Show Me?

Some women panic a bit after going through delivery and finally getting the chance to be alone with their new baby.  They suddenly realize that they don’t know how to change a diaper or that breastfeeding is harder than it looks.  Luckily, there are people on staff at the hospital who can guide you through your first attempts at these tasks.  They can give you tips to help you get your baby to latch for breastfeeding and show you the proper way to take care of their sanitary needs as well.  Ask your chosen hospital about who they have available to go through these questions with you once you have delivered.

If you have more questions, be sure to join me for my live webcast, Inside Information for Women, every Thursday at 1pm Eastern.  I can take your call and do my best to answer any burning questions you might have regarding your pregnancy, delivery, or women’s health in general.  In the meantime, if your due date is approaching, be sure to write down the questions you have, so you will remember to ask each one at your next pregnancy check-up.  That way, when your baby and body are ready to deliver, your mind will be ready too.

 

– Yvonne S. Thornton, M. D., M. P. H.

 

Posted in Childbirth & delivery, Fertility & Infertility, Parenting, Pregnancy, Women's health issues | No Responses »
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What’s Making Depressed Mom’s Deliver Early?

Monday, July 30th, 2012

Nothing messes with our hormone’s more than pregnancy, which is why we feel so emotional during that time.  These emotions can certainly run the gamut, but when a tearful moment turns into weeks of depression, it’s time to call your physician.  There are studies pointing to depression as a factor when it comes to some premature births.  Besides that, it is simply a dangerous state in general for a pregnant or new mom to be in.

Researchers for the North Shore University Health System at the University of Chicago studied 14,000 pregnant women.  Their results showed that among the women who were clinically depressed, 14% delivered before their due date.  In women who were not depressed, preterm births were only at 10%.  Although 4% may not seem like much, when you’re talking about the health of your newborn, 4% is a big increase in odds.  The study did include socioeconomic factors as well, but did not study some other confounding variables.  Despite those flaws, the study found depression to be the common thread in many of the preterm births.

However, this doesn’t mean that being depressed will definitely lead an early delivery.  The way people handle depression can also affect their health and the health of their unborn baby.  Women using antidepressants, eating more comfort foods, drinking or using drugs could all be increasing these odds by not taking care of their depression properly.  Fewer than half of pregnant women in the U.S. are screened for depression. It’s always a good idea to seek out the advice of a physician before self-medicating, whether you are pregnant or not.  A good physician will try to determine the underlying cause of your depression instead of simply treating it.  Also, while it hasn’t been proven that antidepressants themselves may be linked to preterm births absolutely, there are studies suggesting a correlation.  Upon speaking with your physician, they may be able to offer alternative therapies for treating your depression rather than trying to prescribe medication to stop preterm birth——because that medication usually is ineffective with potentially harmful side-effects.

This information isn’t really surprising, as stress has long been known to have negative effects on pregnancy.  With depression being yet another source of stress for soon-to-be mom’s, and a medically-diagnosed one at that, you would be wise to take note of your mood.  It probably won’t stop swinging, but at least that’s better than slipping into long-term sadness.

– Yvonne S. Thornton, M. D., M. P. H.

 

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Fertility Institute Plays God

Monday, June 25th, 2012

For many, having children is an important goal, and when they find that for some reason they cannot, it can be heart wrenching.  Couples can go through years of suffering attempting to conceive, only to find that they are infertile.  When this is discovered, some couples resort to expensive fertility procedures in an attempt to have a child.  One fertility clinic though, decided to capitalize on the desperation of would-be parents by holding a contest offering free in vitro fertilization to the winners.

According to the CDC, 11.8% of women are infertile and 7.3 million of them have used infertility services.  These services are extremely expensive though, and many couples cannot afford them.  Because the services are elective, competition for clients is fierce in the fertility market.  The Sher Fertility Institute decided to embark on a marketing campaign in which couples would compete for their services through a video contest.  Forty-five hopeful couples submitted heart-breaking videos about their struggle to conceive, hoping to woo the judges and win one free cycle of in vitro fertilization.  Only three couples could win, but the amount of attention the institute received more than accomplished their goal of marketing exposure.  Critics of the contest believe that the institute is making light of a very serious situation though, and that they are taking advantage of the desperation of infertile couples in order to boost sales.  With contestants who have suffered five or six miscarriages and even a stillbirth, it seems cruel to get their hopes up with a contest that appears to be the miracle they’ve been waiting for.  Additionally, it doesn’t cause other couples, watching the contest, to consider all aspects of making such a decision.

For the most part, experts seem to agree that in vitro fertilization is safe.  However, they also warn against complications and want would-be parents to be aware of the risks they’re taking.  Professor Nygren, a speaker at the World Congress of Fertility and Sterility in Munich, concluded that there are low levels of increased problems which can come with in vitro fertilization, but these “may be due to the fact that all patients undergoing IVF procedures are patients who already have reproductive problems.”  He also pointed out that there seem to be more complications associated with those who opt for Multiple Embryo Transfer instead of Single Embryo Transfer.

Although the winners of the Sher contest are likely ecstatic at their free IVF cycle, many others are disgusted by the institute’s advertising practices.  If you and your partner are struggling to have a child, be sure to speak with your OB/GYN about all of your options before jumping into a contest where doctors are playing god for a bigger paycheck.

 

– Yvonne S. Thornton, M. D., M. P. H.

 

 

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